Blood transfusion

Simple (Top-Up) Blood Transfusion

Blood transfusion is indicated if:

• There are acute symptoms of anaemia, such dyspnoea, tachycardia, severe weakness
• Haemoglobin level is < 6g/dl
• Haemoglobin level has dropped by > 2g/dl below the steady-state value.

Note : Because the cardiovascular system adjusts to the chronic anaemia, blood transfusion is not routinely indicated in steady state SCD simply for the reason that haemoglobin level is below 8–10g/dl.

Exchange Blood Transfusion

Venesection to reduce the proportion of HbS red cells with transfusion of normal HbA blood is often beneficial in the treatment or prevention of life-threatening and other manifestations of sickle cell disease 5. Hence, the aim in this process of exchange blood transfusion (EBT) is to reduce HbS to 30%. Exchange blood transfusion can be done manually or automatically with a red cell apheresis machine.

Indications for Exchange Blood Transfusion

• Cerebrovascular Accidents (CVAs)
• Acute Chest Syndrome (ACS)
• Prior to major surgery
• Multi-organ failure, including Systemic Marrow Fat Embolism (SMFE)
• Multiple pregnancies
• Prevention of recurrent stroke.

Relative Indications for Exchange Blood Transfusion

• Intractable or very frequent severe crises
• Major priapism unresponsive to other therapy.